NURS 5433 FAMILY 2 NEUROLOGY M-5 EXAM QUESTIONS AND
CORRECT ANSWERS 100% VERIFIED
What are the 6 cardinal symptoms of Parkinson's disease? -ANSWER- Tremor at rest
-Rigidity
-Postural instability
-Bradykinesia
-Tremor
-Autonomic disturbances (depression, psychosis, dementia)
What 2 cardinal signs must be present to diagnose Parkinson Disease? -ANSWER-
Bradykinesia or Tremor at rest must be present
What is the patho behind Parkinson Disease? - ANSWER There is an imbalance between
dopamine and acetylcholine. (low dopamine) due to degeneration of the neurons that
provide dopamine to the striatum
-Acetylcholine is excitatory, so it causes excessive stimulation of the neurons that
release GABA. which contribute to the symptoms
What are the two drug classifications for Parkinson Disease treatment? - ANSWER
Anticholinergics( Benztropine) and Dopaminergic agents(Levodopa)
What do dopaminergic agents do in Parkinson Disease? - ANSWER - enhance activation
of dopamine receptors in the brain. (Levodopa)
-Dopamine agonist are the first-line drug for txt of PD
What is the purpose of administering anticholinergic medications to a Parkinson
Disease patient? - ANSWER -Will inhibit the activation of cholinergic receptors
,(Benztropine)
What are the 3 ways to manage Dyskinesia. - ANSWER - Reduce the dose of Levodopa
-Add Amantadine
-Surgery/ electrical stimulation
Which of the following treatments would you use in a patient with mild symptoms of PD?
- ANSWER MAO-B inhibitors (Selegiline or Rasagiline)
Which treatment would you use in a patient with severe symptoms of PD? - ANSWER
Levodopa-carbidopa combination
What type of diet should a patient eat when receiving levodopa-carbidopa? - ANSWER -
Low Protein Diet (b/c high protein diet reduce the therapeutic effect
Levodopa-carbidopa)
off periods -- -- ANSWER -- Are treated by Combining Levodopa with COMT inhibitors or
MAO-B inhibitors
--off periods occur when dopamine levels drop& pt has more tremors throughout the
day
If a patient asks when they should see beneficial effects of levodopa, what do you say? --
-- ANSWER -- increase over first few months, but also will diminish over time--back to
pre-treatment levels around 5y
How do the COMT inhibitors work? - ANS increasing dopamine synthesis in the striatum
What increases the activity of decarboxylase? - ANS Vitamin B6.decarboxylase is what
levodopa is converted into dopamine by
, What are some s/s of levodopa? - ANS n/v, visual hallucinations, vivid dreams,
psychosis, paranoid ideation, anxiety, agitation, insomnia, impulse control, dyskinesia,
darkens sweat and urine, activates malignant melanoma
What happens when levodopa gets converted to dopamine in the periphery instead of in
the brain? -ANSWER- excessive activation of beta-1 receptors on the heart. you will see
dysrhythmias, postural hypotension.
-prrime patients to get up slowly and drink lots of water and adequate intake of salt to
help prevent this
What medications can reduce levodopa effects? -ANSWER first generation
antipsychotics-chlorpromazine and haloperidol
What happens if you take a MAO-I inhibitor with levodopa? - ANSWER HTN crisis
What is the interaction between levodopa and anticholinergic medications? - ANSWER
enhances action of levodopa
When is ergot derivatives used, such as pramipexole or mirapex? - ANSWER - Early PD
disease and in combo with levodopa in advancing PD.
- Pramipexole is used alone early in PD and with Levodopa in advancing Parkinson
Tolcapone - ANSWER AE: BBW- Liver failure
- Limit treatment to 3 weeks
choose entacapone when pt is having increase on&off periods
What are the AE of the ergot derivatives?Pramipexole - ANSWER n/v, daytime
somnolence, insomnia, constipation, hallucinations, pathologic gambling and
compulsive behaviors
CORRECT ANSWERS 100% VERIFIED
What are the 6 cardinal symptoms of Parkinson's disease? -ANSWER- Tremor at rest
-Rigidity
-Postural instability
-Bradykinesia
-Tremor
-Autonomic disturbances (depression, psychosis, dementia)
What 2 cardinal signs must be present to diagnose Parkinson Disease? -ANSWER-
Bradykinesia or Tremor at rest must be present
What is the patho behind Parkinson Disease? - ANSWER There is an imbalance between
dopamine and acetylcholine. (low dopamine) due to degeneration of the neurons that
provide dopamine to the striatum
-Acetylcholine is excitatory, so it causes excessive stimulation of the neurons that
release GABA. which contribute to the symptoms
What are the two drug classifications for Parkinson Disease treatment? - ANSWER
Anticholinergics( Benztropine) and Dopaminergic agents(Levodopa)
What do dopaminergic agents do in Parkinson Disease? - ANSWER - enhance activation
of dopamine receptors in the brain. (Levodopa)
-Dopamine agonist are the first-line drug for txt of PD
What is the purpose of administering anticholinergic medications to a Parkinson
Disease patient? - ANSWER -Will inhibit the activation of cholinergic receptors
,(Benztropine)
What are the 3 ways to manage Dyskinesia. - ANSWER - Reduce the dose of Levodopa
-Add Amantadine
-Surgery/ electrical stimulation
Which of the following treatments would you use in a patient with mild symptoms of PD?
- ANSWER MAO-B inhibitors (Selegiline or Rasagiline)
Which treatment would you use in a patient with severe symptoms of PD? - ANSWER
Levodopa-carbidopa combination
What type of diet should a patient eat when receiving levodopa-carbidopa? - ANSWER -
Low Protein Diet (b/c high protein diet reduce the therapeutic effect
Levodopa-carbidopa)
off periods -- -- ANSWER -- Are treated by Combining Levodopa with COMT inhibitors or
MAO-B inhibitors
--off periods occur when dopamine levels drop& pt has more tremors throughout the
day
If a patient asks when they should see beneficial effects of levodopa, what do you say? --
-- ANSWER -- increase over first few months, but also will diminish over time--back to
pre-treatment levels around 5y
How do the COMT inhibitors work? - ANS increasing dopamine synthesis in the striatum
What increases the activity of decarboxylase? - ANS Vitamin B6.decarboxylase is what
levodopa is converted into dopamine by
, What are some s/s of levodopa? - ANS n/v, visual hallucinations, vivid dreams,
psychosis, paranoid ideation, anxiety, agitation, insomnia, impulse control, dyskinesia,
darkens sweat and urine, activates malignant melanoma
What happens when levodopa gets converted to dopamine in the periphery instead of in
the brain? -ANSWER- excessive activation of beta-1 receptors on the heart. you will see
dysrhythmias, postural hypotension.
-prrime patients to get up slowly and drink lots of water and adequate intake of salt to
help prevent this
What medications can reduce levodopa effects? -ANSWER first generation
antipsychotics-chlorpromazine and haloperidol
What happens if you take a MAO-I inhibitor with levodopa? - ANSWER HTN crisis
What is the interaction between levodopa and anticholinergic medications? - ANSWER
enhances action of levodopa
When is ergot derivatives used, such as pramipexole or mirapex? - ANSWER - Early PD
disease and in combo with levodopa in advancing PD.
- Pramipexole is used alone early in PD and with Levodopa in advancing Parkinson
Tolcapone - ANSWER AE: BBW- Liver failure
- Limit treatment to 3 weeks
choose entacapone when pt is having increase on&off periods
What are the AE of the ergot derivatives?Pramipexole - ANSWER n/v, daytime
somnolence, insomnia, constipation, hallucinations, pathologic gambling and
compulsive behaviors
